Breastfeeding Mothers

Alternative names:

breast pump information; mom care when breastfeeding; nursing mothers

Recommendations:

MOM'S NUTRITION
The Committee on Nutritional Status During Pregnancy and Lactation at the National Academy of Sciences recommends that lactating women should be encouraged to obtain their nutrients from a well-balanced, varied diet rather than from vitamin-mineral supplements, and to drink enough fluids to alleviate thirst. The committee recommends generous amounts of fruits and vegetables, whole-grain breads and cereals, calcium-rich dairy products, and protein-rich foods such as meats, fish, and legumes. A well-balanced intake adequate in calories is suggested.

BREASTFEEDING DAILY FOOD GUIDE
Milk, Yogurt and Cheese
+- Eat at least 4 servings
Meat, Poultry, Fish, Dry Beans, Eggs and Nuts
+- Eat at least 3 servings
Vegetables
+- Eat at least 3 to 5 servings
Fruits
+- Eat 2 to 4 servings
+- Choose two foods high in Vitamin C and Folic Acid, and one food high in Vitamin A
Bread, Cereal, Rice & Pasta
+- Eat about 6 to 11 servings
Fats, Oils, and Sweets
+- Go Easy!

This is just a guide, you may need to eat more than this based on your size and activity level.

DRINKING TO SATISFY THIRST
Nursing mothers need adequate fluid intake to stay healthy and hydrated. Most experts recommend encouraging drinking enough fluids to satisfy thirst. Eight, 8 ounce servings (64 ounces) of fluid such as water, milk, juice or soup is a good goal.

MOM'S FOODS
Breastfeeding mothers can safely eat any foods they like. Some foods you eat may flavor your breast milk and babies rarely react to this. If your baby is fussy after you eat a certain food, try avoiding that food for a while, then try it again later to see if it is a problem. There is no need to limit your diet excessively, and you should maintain adequate nutrition for yourself and your baby.

CAFFEINE AND ALCOHOL
A nursing mother can safely consume moderate amounts of caffeine (equal to one to two cups of coffee per day) without causing harm to her baby. Excessive caffeine intake may cause agitation and difficulty sleeping for your baby. Alcohol has been found in human milk and can interfere with the milk ejection reflex; alcohol consumption should be avoided while breastfeeding. An occasional drink, not exceeding two ounces of alcohol, may be safe, but you should consult your health care provider about the associated risks. Amounts exceeding two ounces should definitely be avoided.

DRUGS IN HUMAN MILK
Most medications (prescription and over-the-counter medications) will pass into the mother's milk. Breastfeeding mothers should check with their physicians before taking any medications. The American Academy of Pediatrics' Committee on Drugs releases a periodic statement with a list of drugs and their compatibility with breastfeeding. Yours and your baby's doctor is likely to be familiar with this publication and can answer your concerns about breastfeeding while taking medications.

In addition, Dr. Ruth Lawrence, MD, a world-renowned expert based in New York State, offers information on taking medications while breastfeeding through a hot line: (716) 275-0088.

LACTATION AMENORRHEA
Most breastfeeding women do not have normal menstrual periods (lactation amenorrhea). Although the risk of pregnancy is less for a woman experiencing lactation amenorrhea, pregnancy CAN occur during this time.

CONTRACEPTION
Oral contraceptives (birth control pills) are hormone medications and are not recommended for breastfeeding women. These hormones may pass into the breast milk. Prevention of pregnancy during breastfeeding is best controlled with other methods of birth control. Discuss your birth control options with your health care provider.

WORKING OUTSIDE THE HOME
Mothers face unique obstacles in maintaining adequate milk supply once they return to work. With planning, commitment, and skilled use of a breast pump, breastfeeding mothers can maintain their milk supply and continue breastfeeding even after returning to work outside the home. A maternity leave of at least 6 weeks is recommended to establish your milk supply and breastfeeding skills before returning to work. An ideal work place would provide a private room for breastfeeding moms, which can be locked, has a comfortable chair, and an electric breast pump for use by all nursing mothers. However, many moms have had success using a hand breast-pump and a bathroom stall for privacy. An electric breast-pump is much faster and easier to use and can be rented.

MAINTAINING YOUR MILK SUPPLY
Here are some tips which have worked well with many breastfeeding mothers who work an 8-hour day outside the home:
1) Before you return to work, have a helper introduce a bottle to your baby, keeping the special experience of breastfeeding for yourself. Your baby may be confused by a bottle you offer, but will adapt easily with another familiar adult.
2) Two weeks before you return to work, rent an efficient and comfortable breast pump and start building up a supply of frozen milk. If the day you are to return to work arrives, and you don't have a freezer full of breast milk, one bottle of formula fed to your baby is not the end of the world.
3) After returning to work, express milk 2 or 3 times a day, every 2 to 3 hours to continue exclusively breastfeeding. If you can only get one break a day and you are unable to pump a full day's allotment in one pumping, a supplemental bottle of formula may be needed. Be aware however, if bottles of formula are given regularly, your milk supply will decrease accordingly.
4) Nurse your baby immediately before leaving in the morning and immediately upon return from work in late afternoon. Many mothers learn that their babies nurse more frequently in the evenings on days they work. Feed on demand when you are with your baby.
5) If possible, arrange to nurse your baby at lunch time.
6) Try to breast feed exclusively when you are with your baby (evenings, nighttime, weekends).
7) Delegate and share household responsibilities with other members of the family.

BREAST PUMPS
There are a number of breast pumps on the market, with varying degrees of comfort, efficiency and cost. Most require time to develop the skills to use them. Pumps may be hand-operated (manual), battery, or electrically-operated. Costs range from $25 to $60. The most dependable, efficient, and comfortable pumps are electric, have intermittent action (creates and releases suction automatically), and require minimal training. Rental costs range between $25 and $40 per month, plus a one-time purchase of a personal adapter kit (between $25 and $32). Your local lactation consultant can help you make realistic plans and guide you to a supportive breast pump depot.